Spine surgery is typically reserved for serious spinal conditions of the back and neck such as compression injuries and for some conditions that cause severe pain. The structure of the spine and its role as a pathway for nerves make it vulnerable to many painful conditions and susceptible to serious consequences if the pain is left untreated.

The spine provides the axis of the human skeleton. It attaches to the skull, shoulders, ribs and pelvis. The spinal anatomy includes at birth about 33 bones called vertebrae. Some of the lower vertebrae fuse so that an adult has 24 vertebrae lined up atop two other bones. The spine can be divided into four areas:

• The cervical spine in the neck has seven vertebrae.
  
  
• The thoracic spine in the upper back includes 12 vertebrae.
  
  
• The lumbar spine in the lower back features five larger vertebrae.
  
  
• The base of the spine includes the fused sacrum and the fused tailbone (coccyx).

Most vertebrae are ring-shaped, with the thicker part of the ring located facing the front of the body. Separating the vertebrae are thick discs of cartilage called intervertebral discs that help cushion the vertebrae from everyday stresses. The spinal cord and the nerves that attach to it pass through the vertebrae as they branch out from the brain to the body.

The spine has two primary forward curvatures in the thoracic and sacral regions. There are compensating backward curves in the cervical and lumbar vertebrae. These curves provide the spine with resilience and flexibility.

The regions most prone to injury are the cervical spine, which has the greatest range of motion, and the lumbar spine, which supports a lot of weight and is subject to much stress.

Many sources of spinal neck pain and back pain can be treated with nonsurgical pain management methods, such as:

• Physical agents such as thermotherapy, cryotherapy, hydrotherapy or electrical therapy
  
  
• Physical therapy, manipulation therapy or acupuncture
  
  
• Medications such as analgesics or anti-inflammatories
  
  
• Spinal bracing
  
  
• Injection therapy such as facet joint injections or epidural injections.

Usually spine surgery is not performed for only pain. There have to be changes in diagnostic tests (e.g., CAT scan, MRI), along with pain or weakness, before a surgeon is going to perform the surgery.  For only pain, patients are usually referred to pain specialists. However, some conditions (such as spinal stenosis) cannot be cured through nonsurgical treatments.

When surgery is recommended, it may be conventional (also called open) or minimally invasive (endoscopic or arthroscopic). Conventional surgeries require a longer incision and longer recovery period as compared to minimally invasive procedures, in which incisions are often 1 to 2 inches in length. However, not all conditions or patients are appropriate for minimally invasive surgery.

Spine surgery typically involves a posterior approach with incisions in the back, but some use an anterior approach through the abdomen or the front of the neck.